Monitoring
Monkeypox virus DNA has been detected in semen after acute infection in the 2022 global clade II mpox outbreak. Therefore, the UK Health Security Agency (UKHSA) recommends that men who have had a confirmed or highly probable diagnosis should use condoms during sex for 12 weeks after complete recovery (this is in line with advice from the World Health Organization). Following the initial 12 weeks and up to 6 months after recovery, semen samples (and where necessary, oropharyngeal and/or rectal swabs) should be tested for monkeypox virus DNA (by polymerase chain reaction) if the patient:[229]
Is undergoing fertility treatment or planning pregnancy
Is undergoing planned semen storage (e.g., prior to chemotherapy)
Has an immunocompromised sexual partner, including a pregnant partner
Is concerned about transmission to sexual partner(s) for any other reason and requests a test.
A single negative test result after 12 weeks post recovery is considered adequate. If the patient tests positive, repeat samples should be submitted every 2 weeks thereafter and the patient should continue to use condoms until a negative result is obtained. It should also be noted that a positive result does not necessarily indicate that the patient is potentially infectious, only that fragments of DNA have been detected.
These recommendations are based on expert opinion in the absence of a clear evidence base. Follow your local guidance.
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